T cell costimulation blockade blunts pressure overload-induced heart failure

18nonenoneKallikourdis, Marinos; Martini, Elisa; Carullo, Pierluigi; Sardi, Claudia; Roselli, Giuliana; Greco, Carolina M.; Vignali, Debora; Riva, Federica; Ormbostad Berre, Anne Marie; Stølen, Tomas O.; Fumero, Andrea; Faggian, Giuseppe; Di Pasquale, Elisa; Elia, Leonardo; Rumio, Cristiano; Catalucci, Daniele; Papait, Roberto; Condorelli, GianluigiKallikourdis, Marinos; Martini, Elisa; Carullo, Pierluigi; Sardi, Claudia; Roselli, Giuliana; Greco, Carolina M.; Vignali, Debora; Riva, Federica; Ormbostad Berre, Anne Marie; Stølen, Tomas O.; Fumero, Andrea; Faggian, Giuseppe; Di Pasquale, Elisa; Elia, Leonardo; Rumio, Cristiano; Catalucci, Daniele; Papait, Roberto; Condorelli, Gianluig

Epidemiology and aetiology of heart failure.

Heart failure (HF) is a rapidly growing public health issue with an estimated prevalence of >37.7 million individuals globally. HF is a shared chronic phase of cardiac functional impairment secondary to many aetiologies, and patients with HF experience numerous symptoms that affect their quality of life, including dyspnoea, fatigue, poor exercise tolerance, and fluid retention. Although the underlying causes of HF vary according to sex, age, ethnicity, comorbidities, and environment, the majority of cases remain preventable. HF is associated with increased morbidity and mortality, and confers a substantial burden to the health-care system. HF is a leading cause of hospitalization among adults and the elderly. In the USA, the total medical costs for patients with HF are expected to rise from US$20.9 billion in 2012 to$53.1 billion by 2030. Improvements in the medical management of risk factors and HF have stabilized the incidence of this disease in many countries. In this Review, we provide an overview of the latest epidemiological data on HF, and propose future directions for reducing the ever-increasing HF burden

Sex differences in heart failure

Heart failure (HF) represents a global pandemic health problem with a high impact on health-care costs, affecting about 26 million adults worldwide. The overall HF prevalence and incidence are ~2% and ~0.2% per year, respectively, in Western countries, with half of the HF population with reduced ejection fraction (HFpEF) and half with preserved (HFpEF) or mid-range ejection fraction (HFmrEF). Sex differences may exist in HF. More males have HFrEF or HFmrEF and an ischemic etiology, whereas more females have HFpEF and hypertension, diastolic dysfunction, and valvular pathologies as HF etiologies. Females are generally older, have a higher EF, higher frequency of HF-related symptoms, and lower NYHA functional status. Generally, it is observed that female HF patients tend to have more comorbidities such as atrial fibrillation, diabetes, hypertension, anemia, iron deficiency, renal disease, arthritis, frailty, depression, and thyroid abnormalities. However, overall, females have better prognosis in terms of mortality and hospitalization risk compared with men, regardless of EF. Potential sex differences in HF characteristics may be underestimated because of the underrepresentation of females in cardiovascular research and, in particular, the sex imbalance in clinical trial enrollment may avoid to identify sex-specific differences in treatments’ benefit